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Collaboratively seeking to improve contraceptive counselling at the time of an abortion: a case study of quality improvement efforts in Sweden
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Dept Obstet and Gynaecol, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
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2019 (English)In: BMJ SEXUAL and REPRODUCTIVE HEALTH, ISSN 2515-1991, Vol. 45, no 3, p. 190-199Article in journal (Refereed) Published
Abstract [en]

Background Many women find it difficult to choose and initiate a contraceptive method at the time of an abortion. There is a gap between regular clinical practice and existing evidence on motivational and person-centred counselling, as well as on use of long-acting reversible contraception (LARC). This study aims to describe and evaluate a Quality Improvement Collaborative (QIC) designed to enhance contraceptive services, with regard to changes in healthcare professionals (HCPs) counselling in clinical practice, and in womens subsequent choice of, and access to, contraception. Methods Three multiprofessional teams working in abortion services from three hospitals in Sweden, and two women contributing with user experience, participated in a QIC during the period March-November 2017. Using a case study design, we collected and analysed both quantitative and qualitative data. Results Teams agreed on QIC goals, including that amp;gt;= 50% of women would start LARC within 30 days post-abortion, and tested multiple evidence-based changes, aided by the two womens feedback. During the QIC, participating HCPs reported that they gained new knowledge and developed skills in contraceptive counselling at the time of an abortion. The teams welcomed the development of a performance feedback system regarding womens post-abortion contraception. While the majority of women counselled during the QIC chose LARC, only 20%-40% received it within 30 days post-abortion. Conclusion The QIC, incorporating user feedback, helped HCPs to develop capability in providing contraceptive services at the time of an abortion. Timely access to LARC remains a challenge in the present setting.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP , 2019. Vol. 45, no 3, p. 190-199
Keywords [en]
accessibility; long; acting reversible contraception; pregnancy termination; person-centred counselling; user involvement; quality improvement collaboratives
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-161210DOI: 10.1136/bmjsrh-2018-200299ISI: 000486041000004PubMedID: 31289100OAI: oai:DiVA.org:liu-161210DiVA, id: diva2:1365658
Note

Funding Agencies|Futurum; Academy for Healthcare, in the Jonkoping County Council; Medical Research Council of Southeast Sweden (FORSS)

Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25

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Kilander, HelenaBrynhildsen, JanAlehagen, SiwFagerkrantz, Amanda
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Division of Nursing ScienceFaculty of Medicine and Health SciencesDivision of Children's and Women's healthDepartment of Gynaecology and Obstetrics in Linköping
Health Care Service and Management, Health Policy and Services and Health Economy

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CiteExportLink to record
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Citation style
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